Nav: Home

How to create health care centaurs, half doctors and half managers

January 28, 2019

If hospital doctors around the world often struggle to become those health centaurs, half professionals and half managers, that modern healthcare organizations need, the main responsibility is not their resistance to change, but the lack of effective support from the organization, according to a study by Marco Sartirana (CERGAS, Bocconi University), Graeme Currie (Warwick Business School), and Mirko Noordegraaf (Utrecht School of Governance), published by the Public Management Review. «The development of these "hybrid" roles is an interactive process», says Prof. Sartirana, «and where professionals are surrounded by an effective support network we witness successful transformations. Doctors are thus able to become familiar with the new management role, give it meaning, and legitimize it in the professional community.

The drive towards the managerialization of doctors in top roles does not distort their job and professionalism, because it depends on the need to cope with social changes that have transformed the attitude of patients. Today it is necessary to work - and teach how to work - in clinical teams and integrated treatment paths in order to respond to the increasingly widespread cases of multi-morbidity and chronicity. It is also important to measure health outcomes to meet the expectations of citizens, who are increasingly searching the quality of a hospital or department before choosing it. And in this the key responsibility is played by doctors in top positions, because - as happens in any professional organization - clinicians respond first of all to those colleagues who have clinical authority and hold leadership positions.

By analyzing the success story of a large university hospital in the Netherlands, Sartirana and his colleagues identify the organizational actions that can support this transformation. Health care professionals must have decision-making autonomy and a budget to manage («if the doctor is to become also a manager, he must be allowed to act as a manager»); they must be surrounded by quality managerial profiles (for example, the head of HR of the hospital analyzed had held the same role in one of the largest private companies in the Netherlands); working in teams and receiving feedback from qualified individuals from other professions (in the Dutch case, the medical department director works in a collegial body which includes a nursing director, a research director and a financial director); being able to carry out adequate management training; having access to external coaches and fellow mentors who have held the same position in the past.

«Our study», concludes Prof. Sartirana, «shows that the prejudice that doctors are unwilling or unable to undertake this transformation must be overcome. Those professionals who have adequate competence and motivation can become "hybrids", provided they are effectively supported».
-end-
Marco Sartirana, Graeme Currie, Mirko Noordegraaf (2018), Interactive identity work of professionals in management: a hospital case study, Public Management Review,  DOI: 10.1080/14719037.2018.1549269.

Bocconi University

Related Hospital Articles:

Seeing the same GP associated with fewer hospital admissions
Older patients who see the same general practitioner over time experience fewer avoidable admissions to hospital for certain conditions, finds a study published by The BMJ today.
Rethinking hospital alarms
On average, there are about 480,000 patients in hospitals in the US -- each generating about 135 clinical alarms per day.
Fighting hospital germs with sugar
A synthetic sugar-based molecule activates the immune system and could serve as a vaccine against C. difficile bacteria.
Out-of-hospital births are on the rise
United States' out-of-hospital births increased to nearly 60,000 in 2014, continuing a decade-long increase.
In-hospital nocturnal dialysis may be good for the heart
In-hospital nocturnal dialysis may be good for patients' hearts as well as their kidneys, a new study suggests.
Rating hospital readmissions
The clinical and social characteristics of a hospital's patient population explain 50 percent of the difference in readmission rates between the best- and the worst-performing hospitals.
One in 2 dies in hospital
In an Original Article in the current issue of Deutsches Ă„rzteblatt International, Burkhard Dasch and his co-authors analyze for the first time the place of death records for Germany.
Common hospital soap effective in preventing hospital-acquired infections
New study holds hope for a relatively inexpensive way to improve care and prevent the spread of deadly hospital-acquired infections by bathing patients in a common hospital soap.
Henry Ford Hospital study links social, community factors with hospital readmissions
Factors like the level of poverty in a neighborhood, living alone, and age affect a patient's chances of being readmitted to a hospital after discharge, even after possible variations in quality of care in the hospital have been taken into account.
Hospital food safety measures reduce risk of contaminated hospital food
A new study found more than 80 percent of raw chicken used in hospitals in food for patients and staff was contaminated with a form of antibiotic resistant bacteria called extended-spectrum beta-lactamase producing E. coli.

Related Hospital Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".